Comparison of single utility port video-assisted thoracoscopic surgery (VATS) and three-port VATS for non-small cell lung cancer

Abstract

Clinical efficacy of single utility port video-assisted thoracoscopic surgery (VATS) and three-port VATS for patients with non-small cell lung cancer (NSCLC) was compared. A total of 156 patients with NSCLC who underwent VATS in Taizhou Hospital of Zhejiang Province from July 2015 to January 2017 were selected as subjects. They were randomly divided into group A (n=74) and group B (n=82), in which group A was treated with single utility port VATS and group B was treated with three-port VATS. Perioperative indicators such as operation time, intraoperative blood loss, postoperative drainage, removal of drainage tube, lymph node dissection, hospitalization time, postoperative complications, postoperative pain and postoperative quality of life were observed. Expression levels of CRP and IL-6 in serum were detected by enzyme-linked immunosorbent assay (ELISA). There was no significant difference in the operation time, postoperative drainage volume, drainage tube removal time and lymph node dissection between groups A and B (P>0.05). Blood loss and hospitalization time in group A were significantly lower than those in group B (P<0.001). VAS scores at 1–3 days after operation in group A were significantly lower than those in group B (P<0.001). Levels of serum CRP and IL-6 at 1–7 days after operation in group A were significantly lower than those in group B (P<0.001). Incidence of complication in group A was not significantly different from that in group B (P>0.05). Overall quality of life scores of group A and B were significantly lower than the preoperative scores (P<0.001). Overall status score of group A was significantly higher than that of group B (P<0.001). Clinical efficacies of single utility port VATS and three-port VATS were similar. Single utility port VATS can reduce trauma during surgery, reduce stress response, relieve postoperative pain, and facilitate the recovery of postoperative quality of life.

Comparison of single- and triple-port VATS for lung cancer: A meta-analysis

“…As illustrated in Figure 1 , our initial search identified 5,154 potentially references from four databases, from which 5,084 were excluded after screening the titles and abstracts. Ultimately, 13 studies were eligible for inclusion [ 13 , 14 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ]. This selection consisted of 3 articles designed as RCTs [ 13 , 25 , 27 ] and 10 articles designed as cohort studies [ 14 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 26 , 28 ] (with 2 propensity-matched cohort studies [ 18 , 23 ]), with approximately 2,278 participants.…”

“…Ultimately, 13 studies were eligible for inclusion [ 13 , 14 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ]. This selection consisted of 3 articles designed as RCTs [ 13 , 25 , 27 ] and 10 articles designed as cohort studies [ 14 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 26 , 28 ] (with 2 propensity-matched cohort studies [ 18 , 23 ]), with approximately 2,278 participants. Among the included studies, seven published in Chinese [ 19 , 21 , 22 , 24 , 25 , 26 , 27 ] and six in English [ 13 , 14 , 18 , 20 , 23 , 28 ].…”

“…This selection consisted of 3 articles designed as RCTs [ 13 , 25 , 27 ] and 10 articles designed as cohort studies [ 14 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 26 , 28 ] (with 2 propensity-matched cohort studies [ 18 , 23 ]), with approximately 2,278 participants. Among the included studies, seven published in Chinese [ 19 , 21 , 22 , 24 , 25 , 26 , 27 ] and six in English [ 13 , 14 , 18 , 20 , 23 , 28 ]. Eleven studies were conducted in China [ 13 , 14 , 19 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ], whereas others were performed in Korea [ 18 , 20 ].…”

“…Single-port VATS has been developed in recent years, featured by minimal invasion and operation difficulty [ 12 ]. Both randomized controlled trial (RCT) and cohort study have reported that single-port VATS lobectomy showed similar results as triple-port VATS in safety and efficacy [ 13 , 14 ], indicating that single-port VATS lobectomy is a feasible and safe option for lung cancer patients. To the best of our knowledge, no systematic review has evaluated the curative effect between single-port and triple-port VATS for the surgical resection of lung cancer based on different study design.…”

Subxiphoid uniportal thoracoscopic pulmonary segmentectomy for stage I non‐small cell lung cancer: Feasibility, quality of life and financial worthiness

“…In order to further investigate if SVATS segmentectomy deserves going through its prolonged learning curve and more complex technique, we assessed and compared the overall postoperative quality of life score between UVATS and SVATS segmentectomy groups after three months, six months and one year using the Chinese version of Quality of Life Questionnaire‐Lung Cancer 43 (EORTC QLQ‐LC43) . Postoperative quality of life has previously been reported in the literature with regard to the difference between VATS and open approaches as well as between multiport and uniportal approaches in early stage lung cancer . On one hand, the results came out in favor of the VATS approach over thoracotomy and on the other hand in favor of the uniportal over the multiport approach.…”